Adam Updegraff, DO
Allergy & Immunology · Toledo, OHNPI 1255561767
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $350,964 of the $379,237 with a category attached, or 92.5%. Regeneron Healthcare Solutions, Inc. accounts for 73.8% of it on its own, with 10 other manufacturers making up the rest. 2025 is the largest year on record at $201,088, more than ten times the $412 reported in 2019. Among allergy & immunology clinicians in OH with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 304 payments — averaging $1247.49 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Regeneron Healthcare Solutions, Inc.$280K
- Sanofi$99K
- GSK$191
- Genentech USA, Inc.$142
- Amgen$42
- CSL Behring$30
- plus $97 from 5 others
What the payments were for
- Speaking & faculty fees$350,96493%
- Travel & lodging$21,2966%
- Food & beverage$6,9492%
- Education$270%
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Regeneron Healthcare Solutions, Inc. | 214 | $280,041 |
| Sanofi | 55 | $98,693 |
| GSK | 22 | $191 |
| Genentech USA, Inc. | 3 | $142 |
| Amgen(2 entities) | 3 | $42 |
| CSL Behring | 1 | $30 |
| Aimmune Therapeutics, Inc. | 1 | $27 |
| Pfizer | 2 | $23 |
| Lilly USA, LLC | 1 | $21 |
| Novartis | 1 | $14 |
| AstraZeneca | 1 | $12 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
- DUPIXENT$376,045
How this compares
$379,237 in reported general payments places this provider in the 95th percentile of 128 allergy & immunology providers in Ohio.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| Dupixent PenDupilumab | 18 | $150,548 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 105 | $108,074 |
| XolairOmalizumab | 12 | $33,704 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 29 | $27,652 |
| Breo ElliptaFluticasone/Vilanterol | 55 | $27,564 |
| Spiriva RespimatTiotropium Bromide | 12 | $8,263 |
| SymbicortBudesonide/Formoterol Fumarate | 18 | $6,788 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 26 | $4,694 |
| Famotidine | 196 | $2,529 |
| Pantoprazole Sodium | 189 | $1,998 |
| Levocetirizine Dihydrochloride | 120 | $1,951 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 77 | $1,930 |
| Montelukast Sodium | 184 | $1,504 |
| Azelastine Hcl | 18 | $661 |
| Ipratropium Bromide | 22 | $622 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| GSKTrelegy Ellipta, Breo Ellipta | $191 | $135,637160 claims |
| AstraZenecaBreztri Aerosphere, Symbicort | $12 | $34,44047 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 95th percentile of 128 allergy & immunology providers in Ohio.
Other allergy & immunology in Toledo
- Syed RehmanToledo$374K
- Sherlyana SurjaToledo$21K
- Ghassan SafadiToledo$5K
- Sudhir RaoToledo$4K
- Justin GreiweCincinnati$1M
- Jonathan BernsteinCincinnati$810K
- Gordon MyersCincinnati$346K
- Nancy Wasserbauer KingstonRocky River$256K
- David LangCleveland$251K
- James FernandezCleveland$179K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.